Communication is a key skill geriatric doctors must have. Families of older adults must understand complex concepts such as cognitive and functional decline and often make difficult decisions about developing treatment goals. The attending physician must engage with loved ones in a thoughtful way that not only incorporates his or her expertise, but also the patient’s own values.
Yet research shows that doctor-patient communication is in need of significant improvement. At the same time, there is a deficit in formal communication skills training for physicians. An article in the Journal of the American Geriatrics Society details the design and outcomes of a communications skills training program called Geritalk, specifically targeted for geriatric and palliative medicine fellows (physicians who are in the post-residency period of specialty training).
Geritalk was offered to select hospital fellows and trainers as an intensive, two-day retreat off-site. Approximately eighteen geriatric and palliative care fellows participated in large-group training and small-group discussions facilitated by hospital faculty trained in communication skills. These teaching and discussion programs covered topics such as general communication skills (such as avoiding jargon); establishing care goals with patients and their families; delivering bad news; and end-of-life treatment issues.
At the end of the retreat, participants chose two communication skills to practice in the next month. Two months after the retreat, participants completed a course evaluation that included an assessment of their practice on these two skills. Satisfaction with the course was very high, and participants reported statistically significant improvements in how well prepared they felt to discuss important topics of communication. These topics ranged from the ability to express empathy and discussing family concerns at the end of a patient’s life, to discussing religious and ethical issues with patients. Participants also reported frequent practice of their two chosen communication skills, such as avoiding jargon and asking open ended questions.
For privacy and logistical concerns, the study was unable to assess the effect of training on patients and their families, and all assessments were limited to participant self-report. What this study was able to show was that skills-specific, evidence-based communication training programs can encourage physicians to focus on improving crucial communication skills.